Patient Consents and Policies

Seattle Cancer Care Alliance (SCCA) requires the following new patient documents.

SCCA Patient Rights and Responsibilities

SCCA staff is committed to work as a team that includes you as a patient and your family members. SCCA respects the rights of all our patients equally and individually. SCCA does not discriminate against any patient or patient’s family member on the basis of race, color, religion, creed, national origin, sex, age, disability, marital or veteran status, sexual orientation or gender identity. If you feel you experienced discrimination as a patient at SCCA, please contact SCCA’s civil rights coordinator at (206) 606-7154 or integrity@seattlecca.org.

Download SCCA Patient Rights and Responsibilities

Notice of Nondiscrimination and Accessibility

SCCA complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. SCCA does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Notice of Nondiscrimination and Accessibility

Financial Care Agreement

This agreement describes Providers permission to perform all needed and advised healthcare services, including exams, therapies, and medical procedures. Patient gives providers permission to communicate about healthcare, healthcare payment and healthcare operations using telephone, mail, fax and email.

Download Financial Care Agreement

Joint Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Download Notice of Privacy Practices